Office Information

Office
Administration Building, Room 162, 2201 Hull Rd., Fayetteville, NC 28303
Phone Number
Office Hours Mon-Fri
8:00AM to 5:00PM
Email
Krista Smith

Fill-in Forms make it possible for information to be entered while the form is displayed using Word or other various programs.  If you need assistance or require a different version please email Krista Smith at smithk@faytechcc.edu.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A
Academic Agreement Review Checklist Form A-14 Revised: 3/7/13 MS Word
Academic Probation or Suspension Status Form A-17 Revised: 8/14/12 MS Word
Academic Program Catalog Form A-2 Revised: 12/11/15 Submit Electronically
Active Directory/Outlook User Form Form A-13 Revised: 1/14/13 Submit Electronically
Advisory Committee Member Information Form A-34 Revised: 6/10/10 MS Word
Advisory Committee Selection of Officers Form A-35 Revised: 11/2/16 MS Word
Athletic Program Academic Progress Form A-4 Revised: 11/29/18 MS Word
Athletic Mid-Term Checkup Report Form Form A-7 Revised: 12/7/18 Submit Electronically
Annual Departmental Evaluation of Library Collection Form A-5 Revised: 3/7/13 MS Word
Application for Faculty & Staff Form A-19 Revised: 9/11/12 MS Word
Audit Form Form A-6 Revise: 3/28/12 MS Word

B
Bomb Threat Checklist Form B-1 Revised: 1/31/11 MS Word

C
Central Supplies Requisition Form C-48 Revised: 2/19/19 Excel
Club/Organization Officer, List of Form C-12 Revised: 5/3/16 MS Word
Club/Organization Quarterly Financial Report Form C-11 Revised:4/11/19 MS Word
College Assembly Report Recommendation/Response Form C-3 Revised 3/12/12 MS Word
Community Service Leave Approval Form C-39 Revised: 11/2/15 MS Word
Consent and Authorization to Release Confidential Records Form C-1 Revised: 3/19/19 MS Word
Consent for Release of Student Information for Education Record Form C-49 Revised: 3/19/19 MS Word
Construction and Renovation Project Approval Form Form C-21 Revised: 2/20/18 MS Word
Continuing Education Student Registration Data Form Form C-22 Revised: 2/7/18 MS Word
Continuing Education Transcripts Request Form C-4 Revised: 11/18/15 MS Word
Continuing Education Unit Course Approval Form Form C-43 Revised: 1/27/17 MS Word
Contract Request (Part-Time) Form C-6 Revised: 2/8/18 MS Word
Course Repeat Request, Third Attempt Form C-8 Revised: 1/11/19 MS Word
Course Review Checklist – Online Courses & Hybrid Courses Form C-40 Revised: 5/31/2016 MS Word
Course Substitution Form Form C-9 Revised:12/17/2015 MS Word
Course Substitution Form (For pre-approved list) Form C-9 Revised: 7/11/12 Submit Electronically
Counseling Services Referral Form Form C-50 Revised: 11/23/16 MS Word
CPL Equivalency Approval Form Form C-23 Revised: 7/13/12 MS Word
Cross Divisional Employment Approval Form C-7 Revised: 3/21/11 MS Word
Curriculum Program Dean Overrides Form C-37 Revised: 2/2/11 Submit Electronically
Curriculum/Course Change Application Packet Form C-41 Revised: 9/17/13 MS Word
Customer Service Survey for Security Form C-17 Revised: 10/16/17 MS Word

D
Directed Studies Agreement Form D-9 Revised: 6/6/12 MS Word
Disability Disclosure, Individual Form D-1 Revised: 1/11/19 MS Word
Disability Support Services Intake Form Form D-4 Revised: 3/17/15 DSS Webpage
Discrimination/Harassment Complaint Form Form D-8 Revised: 10/23/14 MS Word
Disposal of Surplus and/or Obsolete Equipment Form D-2 Revised: 3/8/13 MS Word
Dissolve a Student Club or Organization Request Form D-13 Revised: 12/16/15 MS Word
Document Control Routing Form Form D-11 Revised: 9/25/13 MS Word
Document of Disability Form D-5 Revised: 6/12/17 MS Word
Donation of Voluntary Shared Leave Form Form D-7 Revised: 12/5/18 MS Word
Driving Authorization Form Form D-6 Revised: 9/27/18 MS Word
Duplicate Degree, Diploma, or Certificate Request Form D-12 Revised: 3/24/17 MS Word

E
Early Alert Form Form E-2 Revised: 1/25/16 Submit Electronically
Election Results Memorandum Form E-7 Revised: 1/1/12 MS Word
Employee Performance Appraisal Form E-32 Revised: 5/11/18 MS Word
Employee Training Checklist Form E-1 Revised: 9/1/17 MS Word
Employment, Full-Time Form E-3 Revised: 10/26/18 MS Word
Employment, Part-Time Form E-4 Revised: 10/26/18 MS Word
Equipment Decision Package Form Form E-5 Revised: 7/14/15 MS Word
Equipment Transfer Form Form E-34 Revised: 3/8/13 MS Word
Equipment Request Form E-28 Revised: 3/7/13 MS Word
Exit Forms – Exit Checkout Form E-13 Revised: 6/1/18 MS Word
Exit Forms – Exit Questionnaire Form E-14 Revised: 1/1/12 MS Word
Expense Decision Package Form, Other Operating Form E-15 Revised: 7/14/15 MS Word

F
F1 Student Responsibility Form Form F-23 Revised: 3/11/13 MS Word
Facilities Decision Package Form Form F-2 Revised: 10/3/18 MS Word
Facilities Inspection Checklist Form F-24 Revised: 4/17/12 MS Word
Facility Request Form Form F-13 Revised 12/14/10 Submit Electronically
Faculty/Staff Move Request Form F-11 Revised: 10/10/17 Excel
Faculty Credentials Form: Alternative Qualification Summary Sheet Form F-14 Revised: 1/1/12 MS Word
Faculty Online Teaching Observation Form F-19 Revised: 9/22/16 MS Word
Faculty Suggested Titles for Addition to Library’s Collection Form F-22 Revised: 3/7/13 MS Word
Faculty Teaching Observation Form F-17 Revised: 9/22/16 MS Word
Faculty Workload Adjustment Approval Form Form F-16 Revised:4/7/17 MS Word
Family Medical Leave Request Form F-8 Revised: 11/17/15 MS Word
FAX Cover Sheet Form F-4 Revised: 9/29/14 MS Word
Field Trip Request Form F-7 Revised: 2/23/17 MS Word
Financial Aid Request form for Certificates & Diplomas Form F-5 Revised: 2/23/17 MS Word
Finish Line Grant-Guidelines Form F-6 Revised: 11/28/18 MS Word
First Aid Supplies Request Form F-18 Revised: 2/29/16 MS Word
FTCC Issued Sports Contract Form F-1 Revised: 9/26/18 MS Word

G
Gift In Kind Donation Form (Directions)  Form G-2 Revised: 9/4/18 PDF
GPA Confirmation Form Form G-5 Revised: 12/8/11 MS Word
Grade Change Request Form Form G-1 Revised: 01/11/18 MS Word
Grade Forgiveness 4 Year Rule Request Form G-8 Revised: 2/28/18 MS Word
Graduation Fee Refund Request Form G-4 Revised: 9/28/17 Submit Electronically
Guest Lecturer Notification Form Form G-3 Revised: 11/2/16 MS Word

H
Health Audit Appeal Form Form H-5 Revised: 2/22/17 MS Word
Honorary Trustee Nomination Form Form H-1 Revised: 2/25/15 MS Word

I
Institutional Review Board (IRB)  Review Protocol Summary Form I-1 Revised: 4/27/18 MS Word
Interlibrary Loan (OCLC) Book Request Form I-11 Revised: 3/7/13 MS Word
International (F1) Application for Admission Form I-9 Revised: 9/29/11 MS Word
International Student Financial Certificate Form I-10 Revised: 10/11/11 MS Word
Interview Approval Form Form I-3 Revised: 12/13/16 MS Word
Interview Guide (FTCC) Form I-12 Revised: 5/25/18 MS Word
Interview Guide Supplement Form I-14 Revised: 3/21/13 MS Word
Interview Target/Question Rating Consensus Sheet Form I-13 Revised: 9/26/18 MS Word

J
None

K
Key/Access Card Approval Form, Part-Time Employee Form K-1 Revised:4/11/18 MS Word

L
Library Orientation Request Form L-20 Revised: 3/8/13 MS Word
Lockout/Tagout Periodic Inspection Form L-16 Revised: 4/26/12 MS Word
Loss or Theft of Equipment Form L-18 Revised: 3/7/13 MS Word

M
Media Services Request Form Form M-6 Revised: 1/1/13 Submit Electronically
Meeting Agenda Form Form M-8 Revised: 2/27/13 MS Word
Meeting Minutes Form Form M-9 Revised: 2/20/13 MS Word
Mentor Checklist Form M-1 Revised:11/9/18 MS Word
Military Tuition Waiver Form Form M-7 Revised: 3/16/15 MS Word
Mitigating Circumstances Report Form M-4 Revised: 11/14/16 MS Word
Model Release Form Form M-10 Revised: 3/8/13 MS Word

N

O
Off Cycle Class Schedule Form O-8 Revised: 3/7/13 MS Word
Online Blackboard Course Development Form O-9 Revised: 5/16/17 MS Word
Overtime Approval Form Form O-2 Revised: 5/26/2016 MS Word

P
Part-Time Employee Data Entry Form P-22 Revised: 5/9/17 MS Word
Part-Time Employee Personnel Approval Form Form P-15 Revised: 10/26/18 MS Word
Part-Time Hourly Time Report Form P-3 Revised: 9/30/14 Excel
Performance Improvement Plan Form P-24 Revised: 7/26/16 MS Word
Petition/Recognition for a Student Club or Organization Form P-6 Revised: 12/14/10 MS Word
Program 2nd Option Request Form Form P-13 Revised: 2/26/16 Submit Electronically
Pre-Entrance Medical Record for International Student Form P-11 Revised: 10/20/11 MS Word
Preliminary Application for Foreign Student Admission Form P-12 Revised: 9/29/11 MS Word
Prerequisite Validation Form Form P-5 Revised 11/25/15 Submit Electronically
President’s Award Nomination Form Form P-26 Revised: 4/8/19 MS Word
Printing & Duplicating Request Form P-2 Revised: 12/13/10 MS Word
Professional Development for Employees Form P-14 Revised: 8/1/17 MS Word
Professional Development Blank Survey Form P-8 Revised: 1/1/12 MS Word
Professional Development Sign-In Roster Form P-20 Revised: 1/1/12 MS Word
Professional Services Agreement Form P-16 Revised: 3/7/13 MS Word
Professional Services Agreement Billing Form Form P-18 Revised: 3/7/13 MS Word
Proficiency Grade Form Form P-4 Revised: 1/22/13 MS Word
Program Approval Request for Employees Form P-9 Revised: 1/3/19 MS Word

Q
None

R
Reinstatement Request Form Form R-17 Revised: 3/8/18 MS Word
Report of Absence (PT Curriculum Faculty) Form R-1 Revised: 3/7/13 MS Word
Report of Absence (Full Time) Form R-3 Revised: 11/17/15 MS Word
Request for Virtual Office Hours Form R-18 Revised: 4/14/10 MS Word
Resign or Retire Memorandum Form R-2 Revised: 7/16/15 MS Word
Rose Garden Reservation Form Form R-11 Revised: 2/9/15 MS Word

S
Salary Decision Package Form Form S-1 Revised: 7/14/15 MS Word
Secondary Employment Approval Form Form S-3 Revised: 11/17/15 MS Word
Security Assistance Request Form S-2 Revised: 10/10/17 MS Word
Sexual Harassment Policy Form S-5 Revised: 1/1/12 MS Word
Social Media Marketing Request, CE Form S-8 Revised: 3/22/17 Submit Electronically
Special Funding Request Form to Student Government Association Form S-7 Revised: 5/17/16 MS Word
Strategic Prioritization List Form S-9 Revised:5/11/17 MS Word
Student Activities Approval Request Form S-10 Revised: 12/15/10 MS Word
Student Club/Organization Request for Student Activities Funding for Special Events Form S-4 Revised: 5/16/16 MS Word
Student Notification of Excused Absence for
Religious or Solemn Observance		 Form S-41 Revised: 3/7/13 MS Word
Student Retention Tracking Form S-22 Revised: 3/16/15 MS Word
Student Tuition/Fee Appeal Form Form S-31 Revised: 2/12/19 MS Word
Supervisor’s Accident Report Form S-6 Revised: 1/31/11 MS Word
Supplies Request Form S-11 Revised: 5/28/13 MS Word
Survey Authorization Form Form S-12 Revised: 3/1/12 MS Word
Syllabus Form S-19 Revised: 6/27/18 MS Word

T
Telephone/Written Reference Check Form T-1 Revised: 5/16/15 MS Word
Time Report for Employee’s Daily and Monthly Form T-2 Revised: 10/30/13 Excel
Time Report for Instructor’s Daily and Monthly Form T-22 Revised: 9/10/09 Excel
Time Sheet Off Campus (Work Study) Form T-26 Revised: 9/30/14 Excel
Time Sheet On Campus (Work Study) Form T-27 Revised: 9/30/14 Excel
Transcript(s)/GED Request Form Form T-17 Revised: 3/12/13 MS Word
Transfer Credit Appeal Form Form T-10 Revised: 11/19/15 Submit Electronically
Transfer Form for International Students Form T-11 Revised: 9/28/11 MS Word
Transmittal Sheet (Blank) Form T-15 Revised: 3/12/13 MS Word
Travel (Local) Daily Log (State Funds) Form T-5 Revised: 2/1/19 Excel
Travel Advance Worksheet, Estimated Form T-3 Revised: 7/13/15 MS Word
Travel Authorization, Blanket Form T-4 Revised: 3/7/13 MS Word
Travel Reimbursement Request Form T-7 Revised: 2/1/19 Excel
Travel Request Form T-6 Revised:3/8/19 MS Word
Tuition for Family Members Moving to this State
Due to Employment, Instate		 Form T-24 Revised: 3/13/13 MS Word
Tuition Free Course Form Form T-8 Revised: 1/9/17 MS Word
Tuition Reimbursement Request Form T-9 Revised: 1/3/19 MS Word
Tuition Waiver Form for Survivors of Deceased Law Enforcement Emergency Workers Form T-25 Revised: 8/17/15 MS Word
Tuition Waiver Form for Tuition Paid by Employers Form T-23 Revised: 3/13/13 MS Word

U
None

V
Verification Report for Continuing Education Form V-1 Revised: 8/7/15 MS Word
Veteran Tuition Waiver Form Form V-2 Revised: 2/26/19 MS Word
Visiting Student Permission to Register at Another College Form V-9 Revised: 8/26/13 MS Word
Voluntary Shared Leave Request Form V-3 Revised: 5/25/17 MS Word

W
Website Update Request Form W-1 Revised: 11/12/15 Submit Electronically
Withdrawal Online Form (Adjunct)  Form W-2 Revised: 3/1/2018 Submit Electronically
Work-Based Learning (WBL) Application Form W-8 Revised: 9/30/16 MS Word
Work-Based Learning Employer Request for a WBL Student Form W-7 Revised:9/30/16 MS Word
Worksheet for Placed Student Information (Work-Based) Form W-10 Revised: 9/28/16 MS Word

X – Y – Z
None